Georgia is prepped to spend millions on tackling the opioid crisis. What do drug users want?

Caption

A pile of fentanyl test strips, used to detect the presence of fentanyl in injectible drugs, sits on a motel room bed in Augusta.

Credit: Sofi Gratas/GPB News

It’s past sundown, and Chandler Seklecki and Sydney McKee pull into a laundromat parking lot in Augusta.

Their job: to distribute supplies that aid in safe drug use. 

“We’re exchanging some syringes, giving them some Narcan,” said Seklecki, who is supported in this work by the Georgia Harm Reduction Coalition. 

This is an example of harm reduction, one step on the continuum of care toward overdose prevention and addiction care. 

At the laundromat, one of their regulars brings them a plastic red bin of used needles, dumping it into the sharps container that Seklecki and McKee drive around with. McKee goes to the trunk of the car, digs through plastic bins filled with supplies and grabs new needles. 

This exchange has been legal since 2019, when Georgia passed a Syringe Service Program law to help prevent the spread of diseases like HIV and Hepatitis C. 

But Seklecki and McKee’s “clients” don't just get needles, they also get clean cookers, cotton — which is used to filter injected drugs — condoms and water. Hepatitis tests are available upon request. There’s also plenty of Narcan, used to reverse opioid overdoses.

Their regular, who wanted to remain anonymous, expresses excitement over the tourniquets included in the kit. 

“It's like Christmas, right?” Seklecki said. 

The hope is all this stuff will keep these women — and their friends — from dying. 

Deaths from synthetic opioid overdoses have skyrocketed in Georgia, up almost 400% from 2018 to 2022. That’s largely fueled by fentanyl, a synthetic opioid that’s taken over the illicit drug supply and is far stronger than heroin and other prescription opioids. 

This, the growing presence of man-made fentanyl analogs — and the animal tranquilizer Xylazine, which is laced into other drugs and sends people to the emergency room with flesh eating wounds — has made recreational drug use far more dangerous than years prior. 

“I think this is stuff that people are entitled to,” McKee said — things to help reduce infection but also to enable safer drug use for people trapped in addiction.

“We isolate them, stigmatize them, and then we wonder why people overdose,” McKee said.

Identifying gaps in care

Over five years, more people have overdosed from opioids here in Richmond County than in any other county within Georgia’s Region 2, a boundary created for opioid settlement fund distribution that also includes Macon and Athens. The state is divided into six regions for this purpose.

The idea is that projects in this community — and others like it — could get grants from court settlements to tackle the opioid epidemic through an application process, which the state Department of Behavioral Health and Developmental Disabilities opened about a month ago.

Projects to be considered must fall within the scope of prevention, harm reduction, treatment, recovery or research. 

The state is expected to receive $638 million from the $26 billion settlement over several years, with 40% earmarked for regional projects. 

• RELATED: Georgia launches website: Here's how to apply for funds from Purdue Pharma's opioid settlement

McKee says it’s vital during this process that people directly affected are heard.

“When you want an expert's opinion you go to the expert — and experts are the users,” she said. “So they have to be included in these big decisions.” 

Of the six Regional Advisory Committees with elected members who will help decide where part of the money goes, each has one person in active recovery. 

When he started harm reduction efforts here, in Richmond County, Seklecki wasn’t yet in recovery. 

“Being an IV user for 20 plus years myself, the fact of the matter is you are going to inject drugs with whatever utensils you've got," Seklecki said. "Like, whatever gear you've got your hands on, it's going to happen.”

Even if that gear is unsafe. 

With donations from other users, he began ordering needles online so he and they would all have a safer alternative.

“If I didn't do something about it, nobody else would,” Seklecki said. 

Today, the supplies they hand out are paid for by the Georgia Harm Reduction Coalition. About 50,000 needles are distributed here every year as part of a network of syringe exchange programs around the state. 

The network hopes if the larger organization applies for funds, that it will trickle down to pay for more of the work they do. 

While some see this work as the first step in helping someone in addiction, others worry harm reduction prolongs drug use.  

But though it doesn’t happen often, Seklecki and McKee also connect people to addiction treatment. 

Where the money could go 

Staying at a motel near the highway are Robby and Sarah. GPB is not using their last names for the sake of privacy. 

With their addition to the sharps container, by now, it’s almost halfway full. 

“This helps a lot, because it gives us a way to stay clean, to stay scar free,” Sarah said. 

While pharmacies are included in that 2019 syringe exchange law, Sarah said she often feels discriminated against if she goes in and asks for needles. The harm reduction workers' monthly visits solve that problem. 

Like at the other stops, both Robby and Sarah also get a bag of Narcan and clean supplies. 

Sarah is what harm reductionists would call a secondary — someone who both benefits personally from a needle exchange, but also shares with others. 

“And that’s the rule, like if we give somebody a couple bags or whatever, we're like, ‘Hey, don't sell these, don't do nothing else with these other than give them to people that need them,’” she said.

But sometimes there’s not enough to go around. 

Sarah remembers a recent call she got about an active overdose, where she sent Robby a mile away, to another motel, to bring a friend Narcan. 

“Like, if we would have had a more abundant supply and we were able to give other people that abundant supply, I might not have got that phone call,” Sarah said. 

Unlike some other major Georgia cities, there is no standalone resource center in Augusta where people can get Narcan. 

“The city hasn't given us any,” said April, who manages the motel to where Robby. "We need more."

So far, that job — flooding the streets with Narcan and safe supplies — has largely fallen on users and those who care about them. 

Six people have overdosed at April’s motel since December. She thinks money should fund more harm reduction. 

“You’d probably see a lot less deaths,” she said. But she also sees a need for treatment. “Another step in the right direction would be to open a clinic close by.”

There’s one rehab center in Augusta that offers intensive inpatient treatment, and two centers that offer outpatient medication to ease opioid use disorder, according to gap analysis reports made by the state behavioral health agency. 

But April says those services should be at a lower price point, and are currently located too far from where the users are. The same gap analysis report points out that other patterns of social determinants, like the high number of people who are underinsured, housing insecure and living below poverty in Augusta, may contribute to the city’s overdose death rates. 

The application for the first round of regional opioid settlement funds closes May 17. By early May, the Department of Behavioral Health and Developmental Disabilities said it had received close to 200 project proposals.